Ureteric injuries during colorectal surgery: strategies for prevention

Injuries to the ureter are a known complication of pelvic surgery and well described during gynaecological procedures. There is however little published recent literature on ureteric injuries during surgery for rectal and sigmoid pathology.

All patients undergoing pelvic colorectal surgery over a 4-year period were identified from data prospectively gathered for the purposes of audit and iatrogenic ureteric injuries identified. This information was cross-checked with data entered in the pathology computer.

Five patients had identified ureteric injuries. An incidence of 1.9% compares favourably with other published series. There was increased morbidity in this group with loss of kidney in one patient, a consequence of the ureteric trauma.

Preoperative imaging of the ureter, ureteric catheterization in selected cases and careful meticulous surgical technique will help prevent damage to the ureters intra-operatively.